Adenotome



C. R; STORZ Oct. 4, 1938.

ADENOTOME Filed June :5, 1937 IN VEN TOR. 62092155 A? ,Sroez, BY

ATTORNEYS.

I N TED ST F- Patented Oct. 4, 1938 PATET OFFlE ADENOTOME Charles R. Sim, St. Louis, o.

Application June 3, 1937, Serial No. 146,130

, 3. Claims.

This invention relates to adenotomes and particularly to an improvement in the structure of such instruments and to an arrangement of parts to control the action of the cutting blade and avoid change insuch action under its conditions of use.

It is a; primary object of the invention to simplify thefstructure of adenotomes, to facilitate the assembly and disassembly thereof, to obtain a smoother action thereof, to permit the use of sheet-metal stampings instead of forgings in such structure, and to arrange the parts so that the moving members are substantially enclosed. It is a further object of the invention to improve the action of the cutting element and to prevent it from bending out of its normal position and thus to avoid damage to either the cutting edge or the parts with which it cfo operates.

In the usual form, an adenotome has a curved frame made up of a stationary and a movable part, the movable part being arranged to slide along the stationary part. Prior to my invention the movable part of the frame has been placed on the outside of the curve, so that when it is moved forwardly the reaction against the cutting element which it propels tends to bow the moving element away from the stationary element, and in extreme cases, tobuckle the moving element. In addition, since the two relatively moving parts of prior structureswe're held together by lugs or clamps of relatively small contact area, this tendency for the moving part to bow away from the stationary part greatly increased the unit pressure at that small contact area, and thus greatly increased the frictional drag between the two parts. In accomplishing the objects of my invention, I place the moving part on the inside of the curve of the adenotome frame so that substantially the entire outer surface of the moving part is in contact with the inner surface of the stationary part. In this construction, the tendency of the moving part to bow outwardly tends to move the two parts closer together; and while as before this increases the unit pressure between the two parts, that pressure is so widely distributed that there is substantially no increase in frictional drag.

I In addition, the stationary part of the frame is preferably made in the shape of a downwardly opening channel, and the moving part is a simple" shaft which is positioned within such channel and has a loose sliding fit therein.

In prior adenotomes of the rigid type, the moving part of the frame is secured to a blade which moves in a curved track formed by parallel-wall grooves opening toward each other, and the forward end of this blade is sharpened to provide the cutting element. By my invention, I taper the grooves of the track, and provide a separate knife which is propelled along the track by a flexible blade to which it is attached; to secure more definite control of the position of the cutting edge.

The accompanying drawing illustrates my invention: In the drawing Fig. l is a plan of an adenotome embodying my invention; Fig. 2 is a side elevation of the frame; Fig. 3 is an enlarged section of the end of the adenotome in which the knife operates; FigJfl is a section taken on the line 4- 3 of Fig. 1; and Fig. 5 is a perspective View of the blade and knife.

The frame of the adenotome is made up of a downwardly opening channel member ID, curved in a plane parallel to the legs of the channel and with such legs on the concave side thereof. The head of the adenotome is secured to the forward end of the channel, as by welding. ,The head consists of a bottom Wall I2 which at its rearward portion lies against the upper surface of the web of the channel It] and at its forward portion is curved upwardly in a direction opposite to the curvature of the frame. This forward portionpof the wall I2 is provided with an opening which extends substantially the entire length of its" curvature. A second wall I3 which overlies the wall I2 at its rearward portion is curved at its forward portion in the same general directionas the wall I 2 and has an opening which registers with the opening in the wall I2. The wall It is spaced from the wall I2 and its curvature is such that the space between the walls tapers from a wide spacing at the rear edge of the alined openings to a smaller space at the front edge of the alined openings.

The walls I2 and I3 are supported by side walls It, which extend upwardly beyond the wall It in the vicinity of the curvature of the walls I2 and I3 to form the sides of a cage I5 which is closed bythe wall IS. The walls I4 thus close the outer sides of the space between the marginal portions of the walls I2 and I3, so that there is formed by such walls a pair of grooves I! of progressively decreasing width which open toward each other.

A flexible blade is slidably mounted in the track formed by the pair of grooves I1, and at its forward end has a knife 2i secured against its lower side. 'The knife 2i extends the full width of the blade 26 so that it extends into the grooves II and overlaps the opening defining marginal edges of the wall I2. Its lower surface is curved to form a riding surface which is readily slidable along the inner surface of the wall [2. A knife edge spaced slightly from such surface of the wall i2 is formed at the forward edge of the knife by meeting'bevel surfaces, the lower bevel extending part way through the knife and the upper bevel extending completely through the blade 25 and part way through the knife 2|.

The central portion of the rearward end of the blade 20 carries a reinforcing plate 22, and the reinforced portion is provided with an opening 23 which overlies a slot 24 through the web of the channel It] and the wall 12.

A shaft 25 which lies within the channel It is operatively connected to the blade by means of a finger 26 which extends upwardly through the slot 24 into the opening 23. The upper end of the finger is turned forwardly to overlie the upper surface of the reinforcement 22 of the blade 20, and thus to hold the blade 22 downwardly toward the wall I2. The shaft 25 extends rearwardly in and beyond the channel I0, and at its end is provided with a stop pin 27 and a finger ring 28. It is held in the channel H] by a C-clamp 29 of which one leg overlies the upper surface of the channel ii] and the other leg underlies the lower surface of the shaft 25. A forward extension of the upper leg of the clamp 29 is mounted on the web of the channel It! by a pivot 32. A rearward extension leads to a second C-clamp 30 with legs situated similarly to those of the clamp 29, and is provided at its rearward portion with a transverse key-hole shaped notch which embraces the rectangular shank of a T-shaped key 33. The thickness of the shank is slightly less than the narrowest portion of the notch, so that it will pass through such narrow portion when in transverse position, but its width is greater than such narrow portion and it is adapted to. be turned in the enlarged portion of the notch to prevent disengagement when it is in a longitudinal position. The C-clamp 29 carries a pair of finger rings 3|, which with the finger ring 28 serve as a means by which the adenotome is manipulated.

In operation, the adenotome is placed against the wall which supports the adenoid, with the adenoid received by the pocket l5 and with the frame inclined downwardly from the adenoid as far as possible so that such wall is engaged by a lower portion of the head of the adenotome. The shaft 25 is then moved forwardly to project the blade 20 and move the knife 2!. As this movement proceeds, the adenotome is rolled on the curve of the wall l2 upwardly, desirably so that as the knife 2| passes a particular portion of the wall [2 such portion will be in engagement with the wall supporting the adenoid.

During this operation, the knife 2! slides along the marginal edges of the wall l 2 across the opening in the walls I2 and i 3 to sever the adenoid and trap it in the cage l5. As has already been pointed out, the edge of the knife 2| is so positioned with respect to the curved under surface of such knife that it will be prevented from engaging the inner surface of the wall i2, and will be thus prevented from damaging such wall or from becoming damaged itself. The maintenance of this condition, especially with the varying curvature which it has been found desirable to give to the wall I2, is obtained by the use of the separate rigid knife 2i which extends the full width of the blade 20 so that it forms of itself the riding surface against the wall 12, in cooperation with the tapered track or grooves IT. The maintenance of this condition is of most importance as the knife approaches the far edge of the opening in the wall l2, for that far edge and the knife edge should have a shearing action. (See the dotted-line position of the knife 2|.) In prior adenotomes, where the cutting element is formed by sharpening the forward edge of the flexible blade, it has been found that under working conditions the sharpened edge of the flexible blade tends to bow out so that its central portion strikes the far edge of the opening, instead of passing such edge with a shearing action. By my invention, this harmful result is avoided.

The use of a track of tapering width is also of advantage in decreasing the bending which is imposed upon the flexible blade 20, and this in turn reduces the friction between such blade and its track, to produce a greater freedom of action.

This result supplements the increase in smoothness of action which is obtained by reason of the construction of the adenotome frame. The shaft 25 slides freely within the channel H] and its entire upper surface forms the riding surface between itself and the channel I!) during'substantially the entire operation of the adenotome under working conditions. This riding surface is of such extensive area that the unit pressure, and in consequence the frictional drag, is never high. Moreover slight irregularities in these surfaces cause no interruption of the smoothness of their relative sliding movement.

The use of the channel It has an additional advantage, in that it permits of a thinner frame structure, and substantially encloses the moving shaft 25. Moreover, the upper end of the finger 25 constitutes but a very small protuberance above the smooth upper surface of the blade, in contradistinction to the usual large joint at this location, which minimizes the chance for injury of the tissues, as of the uvula, adjacent to which such parts operate.

Beyond this, the structure permits the use of relatively inexpensive methods of construction, in that almost all of the parts can be formed from sheet metal by simple stamping and bending operations, as distinguished from the diflicult forging operations necessary in the construction of prior adenotomes. The structure is relatively more simple than prior adenotomes, and this facilitates the assembly and disassembly, and makes more certain that the device will be assembled in proper condition when prepared for use.

I claim as my invention:

1. An adenotome, comprising a frame member curved throughoutsubstantially its entire length, a similarly curved shaft slidably mounted against the concave side of said frame member, a head at the forward end of said member having an oppositely curved fenestrated face, a slidable cutting element mounted to slide across said fenestrum, an operative connection between said shaft and cutting element, and finger pieces respectively on said member and shaft whereby said shaft may be slidingly moved forwardly with respect to said frame member to project said cutting element.

2. An adenotome, comprising a frame member curved throughout substantially its entire length and formed with a channel in its concave side and provided near its forward end with a longitudinal slot through the channel web, a slidable blade overlying said slot on the convex side of said frame member, a shaft in said channel and slidable therealong, a connection between the forward end of the shaft and said blade and releasable when said shaft is disengaged from said channel, a releasable device for confining said shaft in said channel, and means for manipu lating said shaft in said channel.

3. Inan adenotome, a head having a curved rigid wall provided with an Opening for the reception of an adenoid, structure providing a pair 7 of opposed grooves along the sides of said opening and forming a curved guideway across said open- 

